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Atopic Dermatitis (AD) This activity is provided by PRIME Education. There is no fee to participate. This activity is supported by education grants from AbbVie, Inc., Sanofi Genzyme and Regeneron Pharmaceuticals. © 2019 PRIME® Education, LLC. All Rights Reserved.. Overview This downloadable fact‐sheet provides an easy‐to‐follow collection of the latest evidence shaping the treatment and management of psoriasis (PsO) and atopic dermatitis (AD). Learn about validated tools, evidence‐based strategies, and new and emerging targeted therapies that can be incorporated in daily practice to improve outcomes for patients with these conditions. © 2019 PRIME® Education, LLC. All Rights Reserved.. 2 1 Learning Objectives • Identify major barriers to evidence‐based treatment and management in federal and public sectors • Implement appropriate methods for diagnosis and assessment of disease activity • Assess current evidence on targeted biologic and small‐molecule therapies to guide treatment decisions for patients with moderate to severe disease • Monitor treatment responses according to treat‐to‐target principles and methods • Apply current evidence and guidelines to inform treatment decisions for patients with inadequate responses to initial therapies • Incorporate patient‐reported outcomes and shared decision‐making into clinical practice • Apply effective strategies for multidisciplinary care coordination and shared patient management © 2019 PRIME® Education, LLC. All Rights Reserved.. 3 Accreditation In support of improving patient care, PRIME® is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team. This activity was planned by and for the healthcare team, and learners will receive 2.25 Interprofessional Continuing Education (IPCE) credits for learning and change. Physician Credit Designation Statement PRIME Education, LLC (PRIME®) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. PRIME® designates this Enduring material for a maximum of 2.25 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. Physician Assistant Credit Designation Statement PRIME® has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credits for activities planned in accordance with AAPA CME Criteria. This activity is designated for 2.25 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.. Nurse Practitioner Credit Designation Statement PRIME® is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 060815. This activity is approved for 2.25 contact hours of continuing education (which includes 0.9 hours of pharmacology). Pharmacist Credit Designation Statement This Application‐based activity has been approved for 2.25 contact hours (0.225 CEUs) by PRIME® for pharmacists. The Universal Activity Number for this activity is JA0007144‐0000‐19‐087‐H01‐P. Pharmacy CE credits can be electronically submitted to the NABP upon successful completion of the activity. Pharmacists with questions can contact NABP customer service ([email protected]). Nurse Credit Designation Statement PRIME Education, LLC (PRIME®) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. PRIME® designates this activity for 2.25 contact hours. © 2019 PRIME® Education, LLC. All Rights Reserved.. 2 Disclosure Policy PRIME Education, LLC (PRIME®) endorses the standards of the ACCME, as well as those of the AANP, ANCC, and ACPE, which require everyone in a position of controlling the content of a CME/CE activity to disclose all financial relationships with commercial interests related to the activity content. CME/CE activities must be balanced, independent of commercial bias, and designed to improve quality in health care. All recommendations involving clinical medicine must be based on evidence accepted within the medical profession. A conflict of interest is created when individuals in a position of controlling the content of CME/CE activities have a relevant financial relationship with a commercial interest which therefore may bias his/her opinion and teaching. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, stocks, or other financial benefits. PRIME® will identify, review, and resolve all conflicts of interest that speakers, authors, course directors, planners, peer reviewers, or relevant staff disclose prior to an educational activity being delivered to learners. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. Disclosure information for speakers, authors, course directors, planners, peer reviewers, and/or relevant staff is provided with this activity. Presentations that provide information in whole or in part related to non‐FDA‐approved uses of drugs and/or devices will disclose the unlabeled indications or the investigational nature of their proposed uses to the audience. Participants should refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Participants should verify all information and data before treating patients or employing any therapies described in this educational activity. The opinions expressed in the educational activity are those of the presenting faculty and do not necessarily represent the views of PRIME®, ACCME, AANP, ACPE, ANCC, or other relevant accreditation bodies. © 2019 PRIME® Education, LLC. All Rights Reserved.. 5 Faculty Disclosures The following individuals have identified relevant financial relationships with commercial interests to disclose: • Laura K Ferris, MD, PhD (Lead Faculty) Advisory Board/Panel – Dermavant, Janssen Principal Investigator of Research Grant – AbbVie, Amgen, Celgene, Dermavant, Eli Lilly and Company, Janssen, Leo Pharma, Novartis • Grant W Cannon, MD (Lead Faculty) Principal Investigator of Research Grant – Amgen The following individuals have no relevant financial relationships with commercial interests to disclose: • Heidi Wynn Maloni, PhD, ANP‐BC, CNRN, MSCN (Planner) • Ryan Burke, PharmD (Planner) • Mark A Rubin, MD (Reviewer) All PRIME staff participating in planning and content development have no relevant financial relationships with commercial interests to disclose. © 2019 PRIME® Education, LLC. All Rights Reserved.. 6 3 PSORIASIS © 2019 PRIME® Education, LLC. All Rights Reserved.. Unmet Needs in the Treatment and Management © 2019 PRIME® Education, LLC. All Rights Reserved.. 4 Disease and Economic Burden of Psoriasis in the US 7.4 million Americans affected $ 112 – 135 billion per year 8 7.4 Annual Costs (2013) 7 6 Direct Indirect* Comorbidities 5 4 3 2.1 1.8 2 Millions of Adults 1 0.5 19% 0 Psoriasis Rheumatoid Atopic Crohn's 19% 62% Arthritis Dermatitis Disease 30% of patients with psoriasis have moderate‐to‐severe disease *Indirect costs reflects loss of productivity (presenteeism and absenteeism). Rachakonda TD, et al. J Am Acad Dermatol. 2014;70(3):512‐516; Brezinski EA, et al. JAMA Dermatol. 2015;151(6):651‐658. © 2019 PRIME® Education, LLC. All Rights Reserved.. 9 Psoriasis is Associated with Multiple Comorbidities Likely a result of the interplay between environmental and genetic factors, as well as overlapping inflammatory pathways Rheumatologic Cardiovascular • ≈30% of patients with psoriasis develop psoriatic arthritis • ≈60% of patients with moderate‐severe psoriasis have ≥2 established CV risk factors* • ~41% of patients with PsA remain undiagnosed • 40–60% of patients do not receive optimal management for • Joint damage is irreversible and is present in half of patients cardiovascular comorbidities within 2 years of disease onset • Risk for cardiovascular outcomes increases with psoriasis severity and is independent of traditional CV risk factors Other comorbidities include: metabolic syndrome, depression, Crohn's disease, cerebrovascular disease, and chronic pulmonary disease PsA = Psoriatic Arthritis; CV = Cardiovascular; NCEP = National Cholesterol Education Program Adult Treatment Panel. *Established CV Risk factors based on NCEP criteria: men ≥45 years; women ≥55 years; diabetes and/or hypertension; fasting HDL‐C levels ≤40 mg/dL; family history of early coronary artery disease; current smokers. Yeung H, et al. JAMA Dermatol. 2013;149(10):1173–1179; Mehta NN, et al. Am J Med. 2011;124(8):775; Mehta NN, et al. Eur Heart J. 2010;31(8):1000–1006; Gelfand JM, et al. J Invest Dermatol. 2009;129(10):2411–2418; Gelfand JM, et al. JAMA. 2006; 296(14):1735–1741; Kimball AB, et al. J Am Acad Dermatol. 2012;67(1):76–85; McArdle A, et al. Clin Rev Allergy Immunol. 2017. Epub ahead of print; Mease PJ, et al. J Am Acad Dermatol. 2013;69(5):729–735; Ritchlin CT, et al. N Engl J Med. 2017;376(10):957–970. © 2019 PRIME® Education, LLC. All Rights Reserved.. 10 5 Presence of Comorbidities Increases Healthcare Costs for Patients with Psoriasis 114,512 adult patients with PsO identified through the IMPACT Database between 1999‐2004.
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